|WMA1X6C||_________________||@ $17.00/ea =||$|
|WMA2X10C||_________________||@ $25.00/ea =||$|
|WMA4X10C||_________________||@ $55.00/ea =||$|
|WMA4X24C||_________________||@ $70.00/ea =||$|
TOTAL AMOUNT (less freight and handling) = $_________________
SOLD TO: _______________________ P.O. #____________________
_______________________ Date: ____________________
_______________________ Required by: ______________
SHIP TO: _______________________ Credit Card(V,MC,..):_______
_______________________ Authorized by:
Send Order to: Aqua-Sorb Products, LLC
P.O. Box 100, Higdon, AL 35979
Satisfaction Guaranteed, if used in accordance with instructions.
Packaged: 10/box, 10 boxes/case. Handling charge of $5.00
will be added under 10/ea.
Prices FOB Higdon, AL Freight charges will be added.
Shipment by USPS unless otherwise advised by customer.
Terms: Payment with order.
All credit cards accepted. Government/military cards accepted.
If tax exempt, you must furnish current copy of your tax exemption certificate.
Tether lines and weights are integral to each item.
Prices effective: January 1, 2008
To order by mail or fax, copy this page, fill out the form, and send in.
If you wish to order online, click this link. ORDER ONLINE